What Is The Point Of Acupuncture?

A recently released data meta-analysis, published online at www.archinternmed.com, has studied the effects of acupuncture on 17, 922 patients suffering from chronic pain conditions such as osteoarthritis and chronic headaches.

The randomised control trials (RCT) compared the effectiveness of acupuncture against no treatment and "sham" acupuncture. Only studies that were perceived to be unbiased and followed the patients for at least four weeks post-treatment were considered.

A acupuncture practitioner in action ©public domain; Image Credit: Kyle Hunter

Across all the pain conditions, patients who received acupuncture reported significantly reduced pain after four weeks compared to those who received no treatment. Patients who received a sham version of acupuncture (for example, using needles that retracted rather than pierce the skin) also reported reduction in pain, but to a lesser extent although a statistically significant difference was seen.

This difference in effectiveness could well be due to the difficulties in conducting a true double blind trail that involves sticking needles into people. In all likelihood, many patients will have observed that their skin was not actually being pierced; and obviously the therapists would be aware that the needles were false. Or at least, one would hope that they would have noticed.

Smaller differences in acupuncture benefits were seen in trials where the patient’s received ancillary treatments such as physiotherapy and gentle exercise programs lead by physical therapists.

These results show that, whilst acupuncture is effective as a treatment against chronic pain, there are many additional factors to be taken into consideration; for example, the relationship between the acupuncture therapist and the patient likely has an impact on the well-being of the patient. Most people feel improved after spending an hour or so getting one on one treatment of any sort.

This is good news for sufferers in the UK as acupuncture treatments on the NHS are being offered as a viable alternative to strong painkillers which are often addictive with many side effects from long-term use. Unfortunately the NHS offers acupuncture as a treatment for many things, and the placebo effect will only take you so far.

In comparison to this, is an investigation conducted by the National Patient Safety Agency, which reported adverse effects following 10% of acupuncture treatments. Whilst most of these cases are reports of nausea and fainting, some patients reported having needles left in them for hours (long after the therapist had left) with some needles having to be surgically removed.

A few reactions have been more severe. Edzard Ernst of the University of Exeter reports that studies of acupuncture in other countries and outside of the NHS in the UK have shown 86 deaths in the last 45 years due to lung collapse after acupuncture. Whilst these cases are extremely rare, it does suggest that the NHS should refrain from offering acupuncture as a treatment for everything from anxiety to nicotine addiction (as it currently does) until a very large scale RCT can be conducted that shows any benefit at all that will outweigh even the slightest of risk.

Published in The Yorker October 5th 2012